Screening for hypogonadism in diabetes 2008/9: Results from the Cheshire Primary Care cohort

Anderson, Simon; Heald, Adrian; Younger, Novie; Bujawansa, Sumudu; Narayanan, Ram Prakash; McCulloch, A. J.; Jones, H.

doi:10.1016/j.pcd.2011.07.006

Cited by 24 publications

(21 citation statements)

References 31 publications

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“…TT was independently predicted by BMI, age and sex hormone-binding globulin (SHBG) levels. In a primary care setting in the UK, 4.4% of men with T2DM had TT levels <8.0 nmol l −1 and 32% had TT levels <12 nmol l −1 with BMI an independent predictor of low testosterone 17. Of 766 Taiwanese men with T2DM (mean age 62 years; mean BMI 26 kg m −2 ), 33% had a TT <10 nmol l −1 .…”

Section: Prevalence Of Low Testosterone Levels In Men With Diabetes Mmentioning

confidence: 99%

Sex steroids and glucose metabolism

Allan

2014

Asian J Androl

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Testosterone levels are lower in men with metabolic syndrome and type 2 diabetes mellitus (T2DM) and also predict the onset of these adverse metabolic states. Body composition (body mass index, waist circumference) is an important mediator of this relationship. Sex hormone binding globulin is also inversely associated with insulin resistance and T2DM but the data regarding estrogen are inconsistent. Clinical models of androgen deficiency including Klinefelter's syndrome and androgen deprivation therapy in the treatment of advanced prostate cancer confirm the association between androgens and glucose status. Experimental manipulation of the insulin/glucose milieu and suppression of endogenous testicular function suggests the relationship between androgens and insulin sensitivity is bidirectional. Androgen therapy in men without diabetes is not able to differentiate the effect on insulin resistance from that on fat mass, in particular visceral adiposity. Similarly, several small clinical studies have examined the efficacy of exogenous testosterone in men with T2DM, however, the role of androgens, independent of body composition, in modifying insulin resistance is uncertain.

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Section: Prevalence Of Low Testosterone Levels In Men With Diabetes Mmentioning

confidence: 99%

Sex steroids and glucose metabolism

Allan

2014

Asian J Androl

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“…1 The association of ED with CVD increases in the presence of type 2 diabetes, 2 3 and up to a third of those with ED have a comorbid condition including hypertension, 4 peripheral vascular disease (PVD), obesity, 5 smoking or dyslipidaemia. 6 7 Phosphodiesterase type-5 inhibitors (PDE5is) are considered the first-line therapy for treatment of ED 8 and, since their introduction in 1998, concern for their use has diminished in high-risk patients with CVD.…”

mentioning

confidence: 99%

Phosphodiesterase type-5 inhibitor use in type 2 diabetes is associated with a reduction in all-cause mortality

Anderson

Hutchings

Woodward

et al. 2016

Heart

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ObjectiveExperimental evidence has shown potential cardioprotective actions of phosphodiesterase type-5 inhibitors (PDE5is). We investigated whether PDE5i use in patients with type 2 diabetes, with high-attendant cardiovascular risk, was associated with altered mortality in a retrospective cohort study.Research design and methodsBetween January 2007 and May 2015, 5956 men aged 40–89 years diagnosed with type 2 diabetes before 2007 were identified from anonymised electronic health records of 42 general practices in Cheshire, UK, and were followed for 7.5 years. HRs from multivariable survival (accelerated failure time, Weibull) models were used to describe the association between on-demand PDE5i use and all-cause mortality.10.1136/heartjnl-2015-309223.supp1ResultsCompared with non-users, men who are prescribed PDE5is (n=1359) experienced lower percentage of deaths during follow-up (19.1% vs 23.8%) and lower risk of all-cause mortality (unadjusted HR=0.69 (95% CI: 0.64 to 0.79); p<0.001)). The reduction in risk of mortality (HR=0.54 (0.36 to 0.80); p=0.002) remained after adjusting for age, estimated glomerular filtration rate, smoking status, prior cerebrovascular accident (CVA) hypertension, prior myocardial infarction (MI), systolic blood pressure, use of statin, metformin, aspirin and β-blocker medication. PDE5i users had lower rates of incident MI (incidence rate ratio (0.62 (0.49 to 0.80), p<0.0001) with lower mortality (25.7% vs 40.1% deaths; age-adjusted HR=0.60 (0.54 to 0.69); p=0.001) compared with non-users within this subgroup.ConclusionIn a population of men with type 2 diabetes, use of PDE5is was associated with lower risk of overall mortality and mortality in those with a history of acute MI.

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“…The association of ED with CVD increases in the presence of type 2 diabetes, 2 3 and up to a third of those with ED have a comorbid condition including hypertension, 4 peripheral vascular disease (PVD), obesity, 5 smoking or dyslipidaemia. 6 7 Phosphodiesterase type-5 inhibitors (PDE5is) are considered the first-line therapy for treatment of ED 8 and, since their introduction in 1998, concern for their use has diminished in high-risk patients with CVD.…”

mentioning

confidence: 99%

P6.11 Phosphodiesterase Type-5 Inhibitor Use in Type 2 Diabetes Is Associated With a Reduction in All Cause Mortality

Anderson¹,

Hutchings²,

Kwok³

et al. 2014

ARTRES

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Objective Experimental evidence has shown potential cardioprotective actions of phosphodiesterase type-5 inhibitors (PDE5is). We investigated whether PDE5i use in patients with type 2 diabetes, with high-attendant cardiovascular risk, was associated with altered mortality in a retrospective cohort study. Research design and methods Between January 2007 and May 2015, 5956 men aged 40-89 years diagnosed with type 2 diabetes before 2007 were identified from anonymised electronic health records of 42 general practices in Cheshire, UK, and were followed for 7.5 years. HRs from multivariable survival (accelerated failure time, Weibull) models were used to describe the association between on-demand PDE5i use and all-cause mortality.Results Compared with non-users, men who are prescribed PDE5is (n=1359) experienced lower percentage of deaths during follow-up (19.1% vs 23.8%) and lower risk of all-cause mortality (unadjusted HR=0.69 (95% CI: 0.64 to 0.79); p<0.001)). The reduction in risk of mortality (HR=0.54 (0.36 to 0.80); p=0.002) remained after adjusting for age, estimated glomerular filtration rate, smoking status, prior cerebrovascular accident (CVA) hypertension, prior myocardial infarction (MI), systolic blood pressure, use of statin, metformin, aspirin and β-blocker medication. PDE5i users had lower rates of incident MI (incidence rate ratio (0.62 (0.49 to 0.80), p<0.0001) with lower mortality (25.7% vs 40.1% deaths; age-adjusted HR=0.60 (0.54 to 0.69); p=0.001) compared with non-users within this subgroup. Conclusion In a population of men with type 2 diabetes, use of PDE5is was associated with lower risk of overall mortality and mortality in those with a history of acute MI.Erectile dysfunction (ED) is increasingly recognised as an early marker of cardiovascular disease (CVD).

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Screening for hypogonadism in diabetes 2008/9: Results from the Cheshire Primary Care cohort

Cited by 24 publications

References 31 publications

Sex steroids and glucose metabolism

Sex steroids and glucose metabolism

Phosphodiesterase type-5 inhibitor use in type 2 diabetes is associated with a reduction in all-cause mortality

P6.11 Phosphodiesterase Type-5 Inhibitor Use in Type 2 Diabetes Is Associated With a Reduction in All Cause Mortality

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